MEDICARE: JACOB FROST PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA14601	TX

General Provider Information

NPI Number	:	1730759432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB FROST PA-C

Provider Business Mailing Address
First Line	:	7942 AVELLANO
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78250-5153
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5825 CALLAGHAN RD STE 203
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78228-1107
Country	:	US
Telephone Number	:	210-341-9614
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2021
Last Update Date	:	01/25/2026

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Directions to “ JACOB FROST PA-C” Practice Location

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